Truck drivers with untreated sleep apnea have higher crash rate: study

Morris, MN – Commercial truck drivers with obstructive sleep apnea who do not follow prescribed treatment have a crash rate 5 times higher than truckers without the condition, according to a study from the University of Minnesota, Morris.

Sleep apnea is a disorder in which pauses in breathing disrupt sleep. A common symptom is daytime sleepiness, which can result in drowsy driving. The condition is estimated to affect about 25 million U.S. adults.

Researchers examined the results of a large trucking firm’s program for screening, diagnosing and treating obstructive sleep apnea. The study included 1,613 truck drivers who had OSA and the same number of truck drivers without the condition who had similar experience and tenure. Drivers with OSA were given positive airway pressure therapy and an auto-adjusting machine for use at home or in their truck. The machine delivers air through a mask worn by the user during sleep. Nearly 700 drivers fully followed treatment requirements, while almost 600 partially did, and nearly 400 never adhered to it.

The rate of serious, preventable crashes was 5 times higher among truck drivers with OSA who did not follow the PAP therapy compared to drivers without OSA, researchers found.

In contrast, drivers with OSA who completely or somewhat followed the prescribed treatment had a crash rate similar to drivers without the condition.

The study results indicate that untreated OSA is a “pervasive threat to transportation safety,” American Academy of Sleep Medicine President Nathaniel Watson, who did not participate in the study, said in a press release. Watson added that transportation employers should implement sleep apnea screening and treatment.

Requiring screening, diagnosis and treatment for sleep apnea among truck drivers would lower crashes, Stefanos Kales, associate professor in the Department of Environmental Health at the Harvard T.H. Chan School of Public Health, chief of occupational medicine at Cambridge Health Alliance, and senior author of the study, said in a university press release.

The Federal Motor Carrier Safety Administration and the Federal Railroad Administration are considering requirements for transportation workers with OSA. On March 8, the agencies announced an advance notice of proposed rulemaking to gather more information on the effects of OSA on these workers.

“The most surprising result of our study is the strength and robustness of the increase in the crash risk for drivers with sleep apnea who fail to adhere to mandated treatment with positive airway pressure therapy,” Stephen V. Burks, study lead author and professor of economics and management, and principal investigator of the Truckers & Turnover Project at the University of Minnesota, Morris, said in release. “The results of our study support the establishment of obstructive sleep apnea screening standards for all drivers through the commercial driver’s medical exam.”

The accepted manuscript was published online March 21 for subscribers to the journal Sleep.